EASY ONLINE MS ORDER FORM    RETURN TO HOME PAGE

        if you have problems entering your order call it into 402-334-5908

ENTER YOUR DESCRIPTION OF ITEMS ORDERED. CURRENT SALE PRICES WILL BE CHARGED,
EXAMPLE:
EZ 1  CARRIER RAMP   $499.95

EZ 2 FOLDING CARRIER RAMP   $559.95   
OUR BEST SELL, PICTURED AT LEFT

EZ 3 ADJUSTABLE HEIGHT CARRIER   $619.95

EZL 1 VERTICAL LIFT RAMP    $1099.95

 

       
QTY DESCRIPTION OF PRODUCT ORDERED,      COLOR,    SIZE

PRICE EACH

   

   

   
   
   

CREDIT CARD & SHIPPING INFORMATION
SHIPPING ADDRESS MUST BE THE SAME AS CREDIT CARD BILLING ADDRESS.
   
   
Card Name Visa or Master Card only
Card Number   Include - Dash 1234-5678-8765-4321
Expires Date Example: 12/06  or December 06
3 # on card back The last 3 digits on the back right side
First Name First Name as it appears on credit card
Middle Name Middle Name as it appears on credit card
Last Name Last Name as it appears on credit card
Street Address Must be the same as billed on credit card
Address (cont.)
City
State/Province
Zip/Post Code
Country
Best call times Example:  after 5 PM,    12 to 4 PM
Cell Phone
Home Phone
Work Phone Extension
Ship Comment
E-Mail
   
  orders are checked    mon - sat   9 am to 5 pm
  we will acknowledge your order with a e-mail reply
 

if you have problems entering your order call it into 402-334-5908

  thank you for your order 
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Copyright © 2004 KISS, KEEP IT SIMPLE SOFTWARE COMPANY  All rights reserved.